Contrast optimization in arterial spin labeling with multiple post-labeling delays for cerebrovascular assessment
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RESEARCH ARTICLE
Contrast optimization in arterial spin labeling with multiple post‑labeling delays for cerebrovascular assessment André Monteiro Paschoal1,3 · Renata Ferranti Leoni1 · Bernd Uwe Foerster2 · Antonio Carlos dos Santos3 · Octávio Marques Pontes‑Neto3 · Fernando Fernandes Paiva2 Received: 2 April 2020 / Revised: 1 July 2020 / Accepted: 25 August 2020 © European Society for Magnetic Resonance in Medicine and Biology (ESMRMB) 2020
Abstract Objective Improving the readout for arterial spin labeling with multiple post-labeling delays (multi-PLD ASL) through a flip angle (FA) sweep towards increasing contrast-to-noise ratio for long PLD images. Methods Images were acquired from 20 healthy subjects and 14 patients with severe, asymptomatic carotid artery stenosis (ACAS) in a 3T MRI scanner. Multi-PLD ASL images with conventional and proposed (FA sweep) readouts were acquired. For patients, magnetic resonance angiography was used to validate the multi-PLD ASL results. Perfusion values were calculated for brain regions irrigated by the main cerebral arteries and compared by analysis of variance. Results For healthy subjects, better contrast was obtained for long PLDs when using the proposed multi-PLD method compared to the conventional. For both methods, no hemispheric difference of perfusion was observed. For patients, the proposed method facilitated the observation of delayed tissue perfusion, which was not visible for long PLD using the conventional multi-PLD ASL. Conclusion We successfully assessed brain perfusion of patients with asymptomatic CAS using multi-PLD ASL with FA sweep. We were able to show subtle individual differences. Moreover, prolonged arterial transit time in patients was observed, although they were considered asymptomatic, suggesting that it may not be an adequate term to characterize them. Keywords Arterial spin labeling · Flip angle sweep · Multiphase · Brain · Perfusion
Introduction Cerebral Blood Flow (CBF) is an important parameter for the investigation of brain hemodynamics, since a variation of blood flow in brain arteries might severely affect tissue perfusion and neurological functions. It is particularly true Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10334-020-00883-z) contains supplementary material, which is available to authorized users. * Fernando Fernandes Paiva [email protected] 1
Inbrain, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
2
Instituto de Física de São Carlos, Universidade de São Paulo, Av. Trabalhador São‑Carlense, 400, São Carlos, SP 13566‑590, Brazil
3
Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
in neurovascular disorders, such as stroke [1, 2], which is strongly associated with the carotid artery stenosis (CAS) or occlusion due to arterial embolism and hemodynamic compromise [1]. Patients with CAS may be asymptomatic, i.e., with no incidence of ipsilate
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